ALPINE SCHOOL DISTRICT REQUEST FOR OUT-OF-AREA TRANSFER Date of Application _______________ Please check appropriate box:

Please check appropriate box:

 Early Enrollment Period Transfer Application (Submitted between December 1 and the third Friday in February in order to transfer the following school year.)

 Late Enrollment Period Transfer Application (Submitted outside of the early enrollment period.)

 Year requested, 20______

 Current year, 20______  Next year, 20______

Please check one and indicate the year requested:

An enrolled nonresident student shall be permitted to remain enrolled, subject to the same rules and standards as resident students, without renewed applications in subsequent years unless any of the following occurs: • The student graduates or is no longer a Utah resident • The student is suspended or expelled from school • The district determines that enrollment will exceed the open enrollment threshold. Student Name ______________________________ Grade _______ Legal Address _____________________________

Student # ________________________

Phone _____________

City______________________________________ State ________________

Birth date ____________________ Zip _______________________

Boundary School ___________________________ Requested School ___________________________________ Current School _____________________________

Reason for Request _________________________________

I understand that all transfer requests are contingent on early enrollment school capacity ("maximum capacity") or late enrollment school capacity ("adjusted capacity"), special program limitations, staff availability, and/or circumstances under 53A-2-207(4)(c). If this request is granted, I agree to leave my child at the requested school through the end of the requested school year. I understand that I, as parent or guardian, am responsible for transportation of my student to and from school.

____________________________________________ Parent/Guardian Signature Standard Open Enrollment:

Approved

 Denied

___________________________________________ Director of Student Services Date

____________________ _____________________ Home Phone Work Phone Date ____________ ___________________________________________ District Administrator (if required) Date

►A student may be denied an open enrollment opportunity if the student has been suspended or expelled from a public school consistent with 53A-2-208(3)(b). Has the student ever been suspended or expelled from a public school? Yes No If yes, please explain: _________________________________________________________________________________________________ _________________________________________________________________________________________________ ►A student with prior behavioral problems may be granted provisional enrollment provided the student and parent sign an agreement with the school or the school district (1) establishing the conditions of continued enrollment and (2) notifying the parents/student that the student will be excluded from the school if the agreement is violated. The school or school district is responsible for the agreement as allowed under Section 53A-2-208(3)(c). Provisional enrollment: Approved

 Denied

_________________________________________ Director of Student Services Date STUDENT SERVICES | Last Modified 8/2008

Approved per attached agreement _____________________________________________ District Administrator (if required) Date

Student Name ______________________________ Grade _______

Student # ________________________

Does this student have any IEP or 504 accommodations? (Check applicable box/es) IEP  504 If checked, a copy of the current IEP and/or 504 plan must be attached to this form. The receiving principal must consult with the Special Education Department (IEP) or the Department of Human Resources (504 plan). Is this student willing to comply with the policies of Alpine School District? Yes _____ No _____ Explain:______________________________________________________________ _________________________________________ Resident School Principal Signature Date

___________________________________________ Requested School Principal Signature Date

Both principals should discuss the transfer before final approval is given.

This request has been (approved _____) (denied _____) by the transfer principal. Reasons for denial_______________________________________________________________________ A Principal’s signature does not admit a student to a closed school. District authorization could be granted if extenuating circumstances are verified.

GENERAL INFORMATION 1) To be accepted for transfer, space must be available in the school, grade and program requested. 2) The request may be denied in cases where the student has a history of behavior problems, or where the school has been declared closed to out of area requests. 3) Parents or guardians of out of area students may withdraw the student from the out of area school for enrollment in another school: i) by submitting a notice of intent to enroll in the resident school for next school year, by March 15 of the current year. ii) by submitting notice of intent to enroll in another out of area school for the following year, by March 15 of the current year. iii) by gaining approval from the school of attendance and an out of area school to transfer during the school year. 4) Students admitted to an out of area school may remain enrolled without renewed applications for attendance in subsequent years. 5) If attendance at the transfer school is projected to exceed 90% of capacity for the next school year, transfer students may be asked to return to the school of residence. 6) Students may also be returned to their school of residence if they are suspended or expelled from school or they violate agreed upon conditions of enrollment. 7) The parent or guardian of transfer student shall arrange for the students’ own transportation to and from out of area schools. 8) Students seeking to participate in interscholastic competition will be subject to the policies established by the Utah High School Activities Association. Any falsification of the above information will result in cancellation of transfer.

STUDENT SERVICES | Last Modified 8/2008